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1001 Blair Ave Calexico CA 92231-2308 | |
| (760) 768-5055 | |
| (760) 768-5037 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1001 Blair Ave, Calexico, California |
| Authorized Official Name and Position | Mervat G. Kelada (ADMINISTRATOR) |
| Authorized Official Contact | 7605626633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1001 Blair Ave Calexico CA 92231-2308 Ph: (760) 768-5055 | 1001 Blair Ave Calexico CA 92231-2308 Ph: (760) 768-5055 |
| NPI Number | 1699944587 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 02/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699944587 | NPI | - | NPPES |
| 00A483531 | Other | CA | INSURANCE |
| A48353 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A48353 (California) | Primary |
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